Family therapists as front line mental health providers in war‐affected regions: using reflecting teams, scaling questions, and family members in a hospital in Central Africa

Abstract

This paper will illustrate the utilization of systemic family therapy services inside a hospital in a war‐affected region of the Central African Republic. Through an international non‐governmental organization (NGO), the author, a family therapist, provided counselling supervision and services to hospital staff and patients in an area of open conflict in the northern region of the country. In circumstances of chronic insecurity fuelled by both government and rebel forces, families displaced in this region are vulnerable to numerous health conditions and social problems. Family therapy techniques and ideas were used to work with individuals, couples and families presenting with health and social problems resulting from HIV‐TB, infections, chronic malnutrition, acute poisoning and beliefs about sorcery. Case examples illustrate the systems consultation model used with the mental health team in order to expand and promote the sustainability of patient mental healthcare in this underserved region.

Scaling Up Family Therapy in Fragile, Conflict‐Affected States

“…If psychotherapy is political work (Blackwell, ; Watts, ), then designing programming for clients who become clients because of political violence and atrocities is especially so (Charlés, ). Technical assistance in humanitarian mental health projects like those described here requires increased operational awareness to the political, social, and economic causes of suffering (Batniji et al., ).…”

“…Systems approaches and relational understanding can provide a method for understanding how to integrate multiple actors in humanitarian projects. Multiple methods are necessary to appreciate the complexity of circumstances on the ground (Charlés, ). Furthermore, an appreciation of the discourse of well‐being and suffering in fragile, conflict‐affected states—where atrocities are part of the everyday landscape in overt and covert ways—is a type of skill inherent to any systemic practitioner.…”

Geographical, Health Systems’ and Sociocultural Patterns of Tb/Hiv Co- Infected Patients’ Health Seeking Behavior in a Conflict Affected Setting: The Case of Eastern Democratic Republic of Congo

“…It can be argued that it is even more unfortunate if the misinterpretation reflects not simply lack of knowledge but it is used as a way of concealing one's condition. Robust health communication programs, targeting the wider community and even patients' families [25], are required in such settings to address such social issues on a constant basis.…”

Global Mental Health: A Call for Increased Awareness and Action for Family Therapists

“…() created a family‐based mental health program to help traumatized citizens in Kosova. In her article on working with victims of torture in Central Africa, Charles () describes using family therapy concepts in her approach to training counselors and delivering therapy services to individuals and their families. Charles () also describes her work in Libya, Kosovo, and Syria, and highlights the range of challenges therapists face in low resource, conflict‐affected areas.…”